Hyperkalemia Causing Inappropriate Subcutaneous Implantable Cardioverter Defibrillator Shocks in a Patient with End-Stage Renal Disease: A Case Report and Literature Review.

高钾血症导致终末期肾病患者不适当的皮下植入心脏复律除颤器休克 ： 一例病例报告和文献复习。

• 发表时间: Nov 2022
• 来源期刊: Cureus
• DOI: 10.7759/cureus.31137
• PMID: 36505168
• 文章类型: Case Reports
• 作者列表: Botrus B,Mahtani AU,Isber R,Haider MS,Isber N

关键词: chronic renal insufficiency; defibrillator shock; defibrillators; electrodes; end stage renal disease (esrd); hyperkalemia; implantable-cardioverter defibrillator; shock; subcutaneous implantable cardioverter

Abstract

Subcutaneous implantable cardioverter-defibrillators (S-ICD) provide an effective treatment option for ventricular arrhythmias. When compared to transvenous implantable cardioverter-defibrillators (TV-ICDs), S-ICDs have a lower infection rate but a higher rate of inappropriate shocks. In patients with end-stage renal disease (ESRD), significant electrolyte disturbances are commonly seen, such as hyperkalemia, which can cause an increase in T wave amplitude. We present a patient with ESRD on hemodialysis who experienced inappropriate shocks from an S-ICD during sinus rhythm due to hyperkalemia-induced T wave oversensing and highlight related cases in the current literature.

摘要

皮下植入式心脏复律除颤器（S-ICD）为室性心律失常提供了有效的治疗选择。与经静脉植入式心律转复除颤器(TV-ICD)相比,S-ICD的感染率较低，但不适当电击的发生率较高。在终末期肾病（ESRD）患者中，显著的电解质干扰是常见的，比如高钾血症，这会导致T波振幅的增加。我们介绍了一名进行血液透析的ESRD患者，由于高钾血症引起的T波过度感应，在窦性心律期间经历了S-ICD的不当电击，并在当前文献中突出了相关病例。